Evaluate, Diagnose and Treat Septic Shock
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- čas přidán 12. 06. 2024
- What is sepsis?
What is septic shock?
How you diagnosis sepsis and septic shock?
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These are some very basic questions when it comes to understanding sepsis and septic shock...basic but absolutely critical!
As a surgeon I take care of sepsis daily. Whether it's a perforated intestine or an abscess that needs draining or appendicitis. It's critical that I know what to look for and how to make the diagnosis.
If you have trouble answering these questions then you are going to learn a ton today with this talk on Sepsis and Septic Shock.
Fast Forward with these AWESOME Time Stamps
Start 00:00
Why learn sepsis 01:04
Clinical Case for Sepsis 01:33
Epidemiology of Sepsis 02:03
References for Sepsis and Septic Shock 02:33
Defining Sepsis and Septic Shock 03:12
Pathogens in Sepsis 03:33
Screening for Sepsis (SIRS, qSOFA, NEWS) 07:23
Evaluation and Treatment of Sepsis and Septic Shock 09:27
Surviving Sepsis 1 hour bundle 11:48
Antibiotics in Sepsis 13:43
Vasoactive Medications in Sepsis 15:22
Other Concepts in Sepsis 17:30
Summary and Putting it All Together 18:38
REFERENCES
Surviving Sepsis Campaign citizensurgeon.co/survivingsepsis
Norton's Textbook of Surgery citizensurgeon.co/Norton
Sabiston's Textbook of Surgery: citizensurgeon.co/Sabiston
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WHO AM I?
I'm Dr. Erik Pearson, FACS and I am a board certified pediatric surgeon living in Las Vegas. I make surgical education videos on all topics in general surgery as well as talks on lifestyle design as a surgeon, book reviews, and studying effectively. I also write a weekly newsletter called the Saturday Six where I identify Six different discoveries of the week. You can get the weekly newsletter by signing up to the CITIZENSURGEON Community!
Sepsis, Systemic Inflammatory Response Syndrome and Septic Shock are topics in critical care and this video, similar to the Khan Academy lectures and tutorials this video discusses Sepsis, Septic Shock, SIRS, Multiple Organ Dysfunction syndrome, the treatment of septic shock and distributive shock.
DISCLAIMER
While my aim is to help educate you for the ward, the surgical ICU, the operating room and your exams remember these videos are not a replacement for your reading, your medical school and residency preparation and most important your own decision making. Good luck and enjoy!
Affiliate Links - There are a few links in the description that may lead to a kickback to me to help support the channel.
I was admitted 7/19/2023 & it was hell. I just didn’t know what I have, I passed out and don’t know what was going on to my whole body. I woke up in the ICU. All I’m gonna say is; To God Be The Glory For The Great things He has done. And I thank you so much to all the ER staffs, ICU doctors & nurses, wards and all technicians & everyone who were there in the Sutter Health hospital and especially to the “Pacific Inpatient Medical Group “ for your smiling face and your Professional care for me when I was in the hospital. May The Good Lord bless you all abundantly and keep all of you & families in His Loving Arms. Keep it up!!! Job well done!!! GOD BLESS YOU ALL IN THE NAME OF JESUS CHRIST OUR LORD & SAVIOR AMEN ❤❤❤❤❤❤❤
Happy to hear you’re ok! Thanks for sharing your story!
save the religious BS please !!! the medical staff and science kept yu alive . not a ridiculous fairytale cult, worshipping a middle eastern carpenter !! GROW UP
I recently almost didn't make it from Sepsis. I was in the hospital for two months from it. Take care everyone!
Wow, thanks so much for posting and I'm so happy you made it through. Sepsis and Septic shock are severe problems and while I'm sorry this happened to you I'm pumped to see you recovered!
@@citizensurgeon, thank you so much! I am getting there. I still have a long ways to go and on a high amount of oxygen all day, but I think my age and will to live has definitely helped. Recovery has definitely given me a challenge given that I have limited mobility and use a manual wheelchair, but everything will eventually be okay. Thanks again!
5ĺ
@@natashak3387 Glad you are pulling through but it's a shame when one goes through an illness like that ! You are truly blessed even for your current partial recovery .
But my sister ended up with such a dangerous case of sepsis ( supposedly from a urinary tract infection which became worse ) that SHE ALMOST DIED ! ... Personally I see it as negligence ; my brother tells me to not be a troublemaker .
My sister ended up with a TUBE in her KIDNEY several months ago when this occurred and she STILL has that uncomfortable tube in her .
She's been back in the hospital TWICE and now has a BLOOD CLOT in her LUNG .
Each time she has to go back to the hospital , of course , she has such bad COGNITIVE DECLINE from the infection hitting her brain that she can't properly hold a conversation .
I am so worried for her because it's obvious to me she's only going to get worse ... I am so scared for her
Im back doc! Haha the video’s amazing! Timely for my exams next week. Doc may I suggest tackling surgical infections as well? Thank you so much for your videos!
We have missed your videos. Thanks for sharing your knowledge 🙏
Absolutely! More on the way, give me some topics to cover :)
Thank you so much sir,
Hey, you are amazing and this was really helpful. Thank you very much!!!
Happy you enjoy the content, thank you for the feedback!
Thanks for this amazing video.
Thanks so much for engaging! Have a great day!
Excellent explanation. This MD brings it always to the point! Take care and love it guys!
Thank you!
Thank you so much for uploading this. I suffer from recurrent sepsis/septic shock and have been on life support in ICU 3 times now and HDU over 50 times. I usually know I have sepsis when the rigoring starts and extreme muscular pain all over. Our local trains have started displaying sepsis awareness information signs. It's such an important topic and a lot of untrained people are not too sure what signs/symptoms to look out for. You have provided a lot of very helpful information in your video which will help people become more aware of what sepsis is and what to expect treatment wise. I'm sure medical/surgical students will also be grateful for this and help them with their studies. Many thanks again 😊
Thanks so much for engaging and sharing your story, sepsis and septic shock are not only lethal they have devastating long lasting consequences. I hope you continue your recovery!
😢 Bless You I hope you will continually overcome and live well
Thank you doctor for the training ❤
Awesome, pumped you enjoyed it!
Excellent sir
These guidelines helped save my life!
Incredible! Guidelines are so important and as you have experienced are life saving!
Tara , would you be able to explain a little bit more so some people will maybe learn from YOU as well as the doctor ?
I am here to learn about this ! my mom passed way from septic shock 2 days after her major surgeries!
I’m so sorry to hear that Kary, septic shock is absolutely deadly
I’m here to learn how it affects the body as I just lost my mum yesterday after due to sepsis which was due to underlying health conditions she had mainly pulmonary fibrosis of her lungs ❤️🩹
Excellent breakdown of the protocol for Sepsis. My brother is in the hospital right now with it for an infection from both a diabetic ulcer in his big toe and diabetes that we’re both left untreated with for 2 1/2 years. He only supplemented with Berbine, Vitamin D and switched to fasting and only eating meat and vegetables with no carbs to try to help it heal, which actually did seem to help keep it contained, even though it never was able to heal completely. Because he couldn’t afford insurance with the Gig/side work he does as an independent contractor.
I see the hospital he is in is doing a lot of what you mention here. But he was downplaying how long he had this infection in the emergency room in hopes of them not keeping him there and just sending him home with the medications he needs. He won’t allow me to talk to the doctor on his behalf regarding this. So just wanted to know if doctors are also able to tell when people like him are lying and trying to downplay the severity of their symptoms. He refuses to believe me when I tell him he may have sepsis.
Also who can I talk to at the hospital to let them know that he hasn’t told them everything? So I can inform them of this? He didn’t give me or anyone else advanced directive or POA. But I feel I need to let his doctor know this so his doctor can make an informed decision because my brother has an infected tooth also that needs to come out and I confirmed with my brother yesterday that he did not mention this to the doctors either! Sigh
Awesome ❤
Glad you enjoyed it thank you!
Well done -ER DOC
Thanks Dr. Garrity! Glad you enjoyed it!
I had septic shock caused by klepsiebella from an infected picc line. The after effects of septic shock are still problematic my skin is very dry my intestines ache, sometimes so severely laying down standing up nothing relieves the pain. Thankfully I did not have permanent organ damage and I made it out of the icu alive.
Thanks for sharing your story, infected intravascular lines can be life threatening. Im sorry you had this experience.
Even though your name is don't ask , I would like to ask , what is the outcome of all this and are you going to sue because it sounds like you certainly have a good reason with all that suffering .
@@gardensofthegods i’m not looking to sue anyone. Picc lines it’s like a catheter in your vein and they run a high risk of infection. Sometimes risk outweigh the benefit. in my case It was just an unfortunate circumstance. Since then I’ve been meticulous and have maintained septic free with my new picc line.
I think the outcome of septic shock made my already existing digestive issues much worse, i started developing bowel blockages which are now a consistent issue. I’ve been, hospitalized multiple times due to bowel blockages. The bowel blockage is seem to happen regardless of what I consume Even if it’s puréed or in a drinkable form they still happen. Hopefully in time, things will improve.
I’m currently on TPN which is a nutritional IV. I’m really wanting to get off it and I am currently working with my Dietitian trying to find a nutritional formula that I can tolerate, At he same time focusing on both physical and mental health to navigate life as best as I can. ☮️
2 months ago my father collapsed while riding his bike , desorianted and lost .. luckily one bystander saw it and called emergency and he ended up in ICU . He lived in Germany, doctors kept saying he has a bacteria in his kidneys or at least that's how much I understood. He was desorianted pulling out his IV and trying to leave to go home . After few days he went into cardiac arrest, his brain could never recover.... ten days after it all started he was dead . He just turned 66 . It was such a shock to me I still can't get over it . Trying to figure it out I tried to do some research and came to a conclusion that it was most probably sepsis. I heard of it but never knew how dangerous it can be . I don't know if I'm right. Maybe you can confirm if my theory is right .
Do you know us anytime before your dad collapsed if he had had anything like an arthroscopy or any kind of procedure where they could be sticking tubes or cameras in him ? ... because where did the infection come from ?
My sister who was put in a nursing home against her will by two of my siblings who have power of attorney over her and I've been trying to figure out a way to get her out for almost 3 yrs. now but I am 1500 miles away ... she ended up with sepsis a couple of months ago in that nursing home .
To me it's a clear-cut case of neglect because they said she had a urinary tract infection that became sepsis ... !
What ?! I think something went wrong and it's a case of neglect but my brother says don't be a troublemaker .
She ended up with a tube in her KIDNEY and still has it ; it's painful for her and then she ended up back in the hospital or 3rd time .
I am so worried for her and each time the sepsis gets worse she goes into obvious cognitive decline since it affects her brain ... flooding it with the infection .
... plus now she has a blood clot in her lung .
A friend of mine who is the retired Head Nurse who also used to teach nursing said it's not the infection nowadays that kills you but all the drugs they pump you with ... and that the industry doesn't want the public to know .
@@gardensofthegods June 10, 2023, I went to the hospital for what I thought was a cold. I was 67 at the time. For the 2 years before that, I had some strange things go on. Several times my body would shake violently, and my son would have to pile every single blanket plus the heating pad on me. My teeth would be chattering. Also, frequent episodes of violently vomiting nasty green stuff, and a LOT of it. When I went to the doctor, they would often comment that my heart was beating so fast! Finally, I had a time where I began hallucinating. I woke up in a strange place...and I dealt with this place and it's people for about 3-4 days. My son had called an ambulance and the medics basically told him that it was probably because I am on pain medication, and left. My son looked TOTALLY different to me. I thought that there was probably about 8 people in my room and my closet. I was terrified. Finally, my son again called the paramedics because he was terrified. This time he made them take me. Turns out, I had pneumonia in my lower lobe of my left lung. They put in a chest tube and tried to get this huge gross ball of infection to drain. After 2 weeks they let me go. It was really strange. I had NO idea how sick I was. And no one told me how very sick I was! Only after I came home I read my diagnosis; severe pneumonia, severe sepsis. Not at all a journey I care to go on again! I was told that the next time this happened, my journey would be not of this world! Sorry so long! Everyone take care!
Thanks
You are welcome
You are welcome!
August 10 th this year I went into septic shock. They almost missed it. My hospital release form said septic shock…unknown cause. I am a 55 yr old female. In May I had my yearly physical….got a clean bill of health. Few months later…almost died. I’m finally starting to feel like my old self. It definitely takes a lot outta your body. Maybe something for students studying this topic to remember…..not everyone will have a typical in your face reason. Thank goodness for the paramedic…my nurse ..in the ER …he figured it out…and finally got the doctors and staff to get in gear .
Pam, thanks so much for sharing your story, I’m so happy your team ultimately discovered the problem and you are ok, as you pointed out, sepsis is deadly and it doesn’t always play by the book. Thank you for engaging.
My 51 yr old sister kust passed away 2 / 1 hours ago from Sepsis! Long story, but her lungs were filled w fluid and puss! Im devastated
I'm so sorry to hear that, sepsis is such a lethal problem. Thank you for sharing and I hope you are filled with wonderful memories of your sister in this time of grief.
I am here to learn and watch this vedeo because my husband passed away from septic shock last month 😢😢😢 I can't move on until now
Hi, my mother age 57yrs going through septic shock. She is not able to understand things or able to speak clearly. I think they are major symptom of Sepsis.
But now she is out of ICU after abscess removed by surgery. Her vitals are controlled without any medication. Fever is normal, Urine output is normal, BP is normal and Oxygen, pulse as well. Her TLC went to 62000 after surgery, but now dropped to 22000 at day 3 PO.
She has been moved to normal station. My question is how would we know that she is coming out of sepsis? Please respond asap
I'm sorry to hear about your mother and I hope she is recovering from her illness. Unfortunately I can't give medical advice on this channel but certainly write these questions down and ask her medical team. Good luck!
I came here to try and learn about this as my best friend has been down with it since Oct 17th, 2022. Has not walked since going into the hospital and has spent 90+ percent his time in the hospital. every time they get him to the point he can go home (in home health care) he only lasts a few days before he is back in the hospital ICU with what we are being told is a different type of septic. I know very little about anything medical, but I am struggling to understand how this keeps coming back time after time. I don't know if this is relevant, but he did have a very bad bout with COVID at the end of 2021 where he was on a respirator for 12 days and had to go through a lot of PT to get his full mobility back.... again not sure if that means anything.
I'm sorry to hear about your friend Thrill, it sounds like he was incredibly ill. I hope he continues to recover.
In report we have found 90.6 procalcitonin level
Does this is indicative of sepsis doctor may not confirmed yet 😢
Intresting to watch this video and get to know more about septic shock. My dear mom got sick and got septic shock, 12 days later she died 💔
I’m so sorry to hear that about your mom and thank you for sharing. I’m thankful that this video helped give you some insight into your mother’s sickness. Be well, safe, in good health and high spirits.
@@citizensurgeon Thanks !
Jenny , yours is the exact same name of my sister who was put in a nursing home against her will by 2 siblings of mine who have power of attorney over her .
I am about 1,500 miles away and so far powerless to try to bring her to live with me .
But I am so worried sick for my sister Jenny who is much older than me and was born birth defected .
Several months ago she ALMOST DIED from SEPSIS and I found out it was from a bad URINARY TRACT INFECTION ( which to me spells NEGLIGENCE ) .
I KNEW something was wrong because she could barely carry on a conversation and I contacted my brother about this ; about 2 days later he called saying she almost died ... that's when I found all this out from my brother about the UTI and it had caused her sepsis but NOBODY NOTICED until it almost killed her ! ?
Several months later she still has a tube in her kidney , which is painful for her ... and each time she goes back to the hospital with the sepsis she is worse ... with more problems ; now this time there's a BLOOD CLOT in her LUNG .
I don't know what to do at this point , I do believe that the longer she is there I thought nursing home the sooner she will die
AC/Df surgery from untreated mrsa…now site is infected should I be concerned
I’m sorry to hear that, I can’t provide medical advice on the platform but I would certainly reach out to your surgeon or physician!
I'm confused are you saying this was surgery to remove a herniated disc ?
Can you please tell us now how this person is doing ?
Can we prevent ourselves for getting sepsis ?
Great question…
There are a number of things that people can do to help prevent sepsis, including:
Get vaccinated: Vaccinations can help protect against some of the infections that can lead to sepsis, such as pneumonia, influenza, and tetanus.
Practice good hygiene: This includes washing your hands often with soap and water, especially after using the bathroom, before eating, and after being around someone who is sick.
Take care of chronic conditions: If you have a chronic condition, such as diabetes or heart disease, it is important to manage it well. This will help keep your immune system strong and make it less likely that you will develop an infection.
Get medical attention promptly: If you think you have an infection, see a doctor right away. Early treatment can help prevent sepsis from developing.
If you or someone you know is showing signs of sepsis, such as fever, chills, rapid breathing, confusion, or a rash, seek medical attention immediately. Sepsis is a medical emergency and early treatment is essential.
Here are some additional tips for preventing sepsis:
Avoid contact with sick people. If you can, avoid contact with people who are sick, especially if they have a respiratory infection.
Keep your home clean. This will help prevent the spread of germs.
Get enough sleep. When you're well-rested, your body is better able to fight off infection.
Eat a healthy diet. A healthy diet will give your body the nutrients it needs to stay healthy.
Manage stress. Stress can weaken your immune system, making you more susceptible to infection.
Answer assisted by Bard
Reference
www.worldsepsisday.org/sepsisfaq
Can a septic patient have surgery?
Sometimes a septic patient needs to have surgery for source control. For example a bowel perforation, abscess or anastomotic leak. In elective cases we usually avoid operating patients who may be bacteremic and certainly avoid if sepsis.
Is ARDS common in SEPSIS?
Yes, ARDS is common, especially in septic shock! And ARDS is a lethal problem with significant mortality risk. Great question.
Hi Dr, do you think that these could have been detected early enough to save my brother's life.
He is 72
Admitted because of Acute gastro & struggling to Urinate
I’m so sorry for your life and thank you for reaching out Francois. Unfortunately I can’t make any judgements as I was not involved in the care but I would certainly reach out to the doctors involved who could answer these questions. Wish you the best in grieving for your brother.
Francois , I have to wonder if his struggle to urinate was prostate problems ?
Do you know if he had trouble with his prostate gland ?
Francois , do you know if your brother had any kind of kidney stones , gallstones , liver stones ... anything like that ?
I am so much afraid of sepsis.. after my food poisoning.... i keep on checking for heart rate... temp chills... i am so high on anxiety😥
Umar, I hope you are feeling better!
Do you have sepsis , though ?
Do you have an Indian Grocers near you ?
If so neem powder which has been used for thousands of years and has virtually no side effects is a powerful way to kill infections , fungus , etc .
You take a teaspoon of it in a tall glass of warm water but make sure you do some deal with it as it is very drying to the body inside and out .
There are many all natural things you can take for anxiety some of them are even nootropics meaning they are brain food and make you smarter .
Please see if any health food stores near you have what is called BUTTERFLY BLUE PEA TEA , it is very good for the brain and even helps lower blood pressure if that is a problem .
It turns the water a very vivid blue and is good for many things ... and is very good for the brain .
It's botanical name is Clitoria Ternatea and in some of the Indian Grocers it is called something like Shankhpushpi ...
It is very good for reversing memory loss also .
Another powerful healer is good quality BLACK SEED OIL .
Are you still having chills ?
How are you feeling now ?
I figured out i had post septic syndrome , after septic in 2021.
My dad passed away after surgery..😢
I’m sorry to hear that Sushma, sepsis is deadly, wishing you and your family strength during your grief
and if any one saved a life, it would be as if he saved the life of the whole people. -Quran
May Allah grant you paradise
That’s very kind of you, will keep making good content and I hope it helps you along your journey. allah yusallmak!
@@citizensurgeon Thank god we found your vedios! absolutely they will help, absolutely amazing! Thank you
Pls help me
Alan , please tell us what is going on now 3 weeks later ?
A tooth abscess can cause sepsis, in fact it can look like sarcoid
Thanks Delmar, absolutely agree
I've been an advocate for others, worked in the medical field and have also witnessed what goes on in the back office. No one here would believe it, but you would.
I also had sepsis, hospitalised for 9 days, it was an insurance feeding frenzy for five different specialists who used different diagnosis tactics to keep the insurance paying, no bona fide diagnosis, they skipped over the infected molar.
My husband died from this
I'm so sorry to hear that Chandra, Sepsis and especially septic shock are incredibly deadly. Very sorry for you and your family's loss.
Chandra ... wow , this makes me very sad for both your husband and you .
Sorry to hear this .
Please if you can talk about it can you tell us how they think your husband got sepsis and how long he suffered with it before he died ?
If you don't wish to talk about it , that is fine ... I understand .
My husband is very sick with it now. I'm trying to understand what's going on.
Dude after watching this video I believe the hospital misdiagnosed me I had SEPSIS I had a mrsa infection which lead to me one day waking up SHAKING AND POURING SWEAT FREEZING COLD AND IN THE WORST PAIN IVE EVER FELT IN MY LIFE…I COULD NOT urinate for days I was vomiting And my white blood cells were elevated the doctors kept saying they didn’t know why they said my body was fighting an infection but they couldn’t figure out what from I couldn’t breath my chest was tight they end up diagnosing me with diverticulitis this video hit the nail right on the head I’m POSITIVE I had sepsis
I’m sorry to hear you were sick, it sounds like you were really sick and sepsis is certainly a possibility when infections become severe. I hope the information provided some clarity and I wish you the best in your recovery!
Sounds exactly like my story I suffered a few years with the infection my pcp , the obgyn and the er never treated me or even charted it , now 6 years later I'm suffering big time
How are you now?